Assessment of Al18F-NOTA-FAPI-04 PET/CT imaging for visualization and localization of ovarian and peritoneal endometriotic lesions in a rat model
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Al 18F-NOTA-FAPI-04 PET/CT effectively visualized and differentiated ovarian and peritoneal endometriotic lesions from normal tissues in a rat model.
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Abstract
Endometriosis, a prevalent chronic inflammatory gynecological disorder, is characterized by the ectopic implantation of functional endometrial tissue outside the uterine cavity and is increasingly recognized as a fibrotic condition. The fibroblast activation protein inhibitor ([ 18 F] FAPI) represents a novel radiotracer targeting fibroblast activation protein (FAP), demonstrating significant promise in imaging both benign and malignant pathologies. This study aimed to investigate the efficacy of [ 18 F] FAPI as a non-invasive tracer for detecting ovarian and peritoneal endometriosis. An endometriosis model was established in Sprague-Dawley rats via autologous transplantation of uterine endometrial tissue to the contralateral ovary and abdominal wall. Small-animal PET/CT imaging was performed 60 min post-injection of Al 18 F-NOTA-FAPI-04. Quantitative analysis revealed significantly higher tracer uptake in ovarian endometriotic lesions (OELs; SUV max = 2.53 ± 0.61) compared to adjacent non-lesional ovarian tissue (sOEL; 1.28 ± 0.46, P = 0.031) and contralateral ovarian tissue (CO; 1.15 ± 0.49, P = 0.016). Similarly, peritoneal endometriotic lesions (PELs) exhibited elevated uptake (SUV max = 1.74 ± 0.15) relative to surrounding peritoneal endometriotic lesions (sPEL; 0.97 ± 0.13, P = 0.001) and abdominal wall muscle (AWM; 0.83 ± 0.12, P = 0.0004). Histopathological and immunohistochemical analyses further validated the imaging findings. These results demonstrate that Al 18 F-NOTA-FAPI-04 PET/CT can effectively differentiate endometriotic lesions from normal tissues, highlighting its potential as a non-invasive diagnostic tool for endometriosis.
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